A prospective comparison of endoscopic ultrasound-guided fine needle aspiration results obtained in the same lesion, with and without the needle stylet
Bibliographic record
Abstract
Corrected by: A prospective comparison of endoscopic ultrasound-guided fine needle aspiration results obtained in the same lesion, with and without the needle stylet Endoscopy 2011; 43(02): 168-168 DOI: 10.1055/s-0030-1256175 See also: Commentaire de travail de A. V. Sahai et al., pp. 900 Endoscopy 2010; 42(11): 995-995 DOI: 10.1055/s-0032-1306708 Background and study aims: The effectiveness of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) with (S+) and without (S–) a stylet has never been compared. We prospectively compared the yield for malignancy and sample quality of S+ and S– EUS-FNA. Patients and methods: S+ or S– EUS-FNA was performed on consecutive solid lesions, with a 22-gauge needle, with systematic assignment of S+ or S– passes in a 1 : 2 ratio. Slides were read by a single, blinded cytologist and were rated for bloodiness, adequacy, and presence of malignancy. The yield for malignancy was compared only in lesions in which equal numbers of S+ and S– passes were performed. Results: A total of 309 passes (mean 2.3 passes/lesion, range 1 – 6, 82 % adequate, 38 % S+, 62 % S–) were performed on 135 lesions (63 % malignant, 42 % nodes, 58 % masses [79 % pancreatic]) in 111 patients (mean age 62.9 years, range 30 – 86). In 46 lesions where an equal number (53 S+ and 53 S–) of passes was performed, there was no difference in the proportion of cases in which S+ FNA was “equal to or better than” S– FNA ([S+] 89 % vs. [S–] 87 %; P > 0.05). The results of the two methods agreed in 80 % cases (kappa 0.60). The sensitivities for malignancy were: S+ 87 % vs. S– 83 %, P > 0.05. Specificities were 100 %. Sample adequacy was significantly lower in S+ passes (75 % vs. 87 %, P = 0.013), and sample bloodiness was significantly higher (75 % vs. 52 %, P < 0.0001). Conclusions: Use of the stylet with EUS-FNA does not increase the yield for malignancy and is associated with poorer sample quality. The value of the stylet for EUS-FNA is questionable and requires further investigation.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".